Sick puppy--need veterinary advice

We do a lot of animal rescue work on Okinawa, and recently we found a pregnant dog who gave birth 2 days later. All the puppies were doing really well the first 3 weeks, then one of them, Blitzen, just kind of stopped growing. The others were walking and then running around, and she can barely walk, even now, a week later. She was the fattest puppy for the first three weeks, now the others are more than twice her size. They will be five weeks old tuesday.

The vet situation over here is difficult–please see my OP on this thread for details–but we took her to a Japanese vet about 4 days ago. They took x-rays (which looked normal), did a fecal exam, (which showed no parasites) listened to heart and lungs, everything seems OK. They gave us a course of antibiotics, which she has been on for 4 days now with no improvement. They suggested bloodwork, but we have a limit on how much we can spend on a stray puppy, and this was getting expensive (we have 10 animals under our care right now, and I’m not convinced the bloodwork was going to be very helpful).

She isn’t OK. She can still barely walk. She cries a lot, shivers a lot (we keep a heating pad on her most of the time), sleeps more than the other puppies, and has chronic diarrhea (the others do not).

The only thing I can find that seems to fit this is swimming puppy syndrome, but most sources say problems are present at birth, and I went back and looked at the old pictures, and she isn’t on her stomach any more than the other pups. Everything was fine until she started trying to walk. And I don’t get how the soft stools are related. Still, we’re doing some of the suggested therapies–moving her legs a lot, trying to keep her off her stomach, making sure she nurses on her side. There hasn’t been any real improvement. She can walk a few steps, then the back legs give out, which has been the case from the beginning.

Some sites say that most puppies come out of it fine, some say that 90% die. I don’t know what to think, or even if swimming puppy syndrome is what we’re dealing with.

She still nurses well, but isn’t transitioning to puppy food as well as the others.

What do you think? Any advice would be very much appreciated.

I have absolutely no idea. Some sort of weird metabolic disorder, maybe. Sometimes with congenital organ dysfunction the organ can handle the load up till the pet reaches a certain size or there’s some sort of additional strain on the system. That’s why you typically don’t see signs of liver shunts until the puppy is 8 weeks or so old.

Actually, come to think of it, those symptoms are all fairly consistent with a portosystemic shunt. Three weeks is freaky young to start showing symptoms already, but I guess it’s possible. Diagnosis of a shunt isn’t typically cheap, it involves the metabolic panel your vet has already suggested plus a bile acids panel that has to be sent to an outside vet. Treatment of a shunt isn’t cheap either. Some can be managed with a medication regimen, and others are surgical cases. If that’s the problem, it’s probably more than you want to get into with a stray.

That’s going to be the case with pretty much any metabolic issues; the bulk of the ones that would show this early are either untreatable or rather spendy. At this point, I probably wouldn’t do the bloodwork–if you find out she’s got something treatable but expensive, it’s really only going to make you feel worse than you already do. And if the bloodwork is normal, or it’s abnormal but she’s untreatable…

If this were my puppy, I’d put her down. It sounds like she’s not getting any joy out of life, and it’s really unlikely she’s going to get better. I think it’s really the kindest thing, not that that makes you feel the first little shred better about it. I’m sorry.

My first guess is she’s not getting enough to eat because puppies only cry when hungry or cold(as a general rule of thumb). The diarrhea might be making it hard for her body to absorb the nutrients it needs and she might even be getting dehydrated if it’s really bad. Have you tried supplementing her food with puppy formula or syringe feeding her a high caloric canned food such as Science Diet a/d?
It might be parasites still since it’s possible to miss some of the nastier ones like giardia during a routine fecal exam. I’m kinda fuzzy though on whether or not it’s possible for a 5 week puppy to have giardia though. Poor thing sounds like she’s really struggling to survive and as mentioned it may be best to put her down. But try supplementing her food to see if that helps.

Thanks for the replies, guys. She has actually shown some improvement since yesterday–last night and this morning she was walking pretty well–not as good as the others, who are running now, but quite a lot better. She’s also crying less, but still seems to be having trouble maintaining body temperature (when we took her to the vet, it was a little low (37.5c–99.5f).

The comment about not getting enough to eat is interesting. I’m home all day with them, and it seems like she’s getting plenty of nursing–I’m paying special attention to it, and even making sure she has special nursing sessions alone, since she isn’t eating puppy food well. However, when we offer them water, she drinks a ton, and the other puppies are not terribly interested.

Diarrea is still present. The thing about the worms–the Japanese won’t deworm unless they see something in the stool (they also refuse to give vaccines within a week of even basic de-worming) and they didn’t see anything, so if I want dewormer, I’ll have to go to the American vet, which I’ve been trying to get an appointment with for a week with no luck. Maddening. And if the diarrhea was caused by worms, wouldn’t they all have it?

As far as a shunt–if that’s the problem, unfortunately, she’ll have to be put down. We aren’t doing surgery on this puppy, there are too many healthy dogs on this island put to sleep every day. But the Japanese are very reluctant to put dogs to sleep, unless they’re in the pound. It’s strange. I’d probably have to do it at the american vet, which, again, I can’t get an appointment with.

I guess we’ll give her another few days, continuing some of the swimming puppy treatments, which are kind of a pain but free, and see if she continues to improve.

If anyone else has any ideas, especially about the water consumption, I’d love to hear them.

Many many years ago I raised a litter that was born in the boarding kennel I was managing and about the time that I started weaning the pups, one of them had the sort of symptoms you describe. Turned out there was something wrong with the puppy’s intestines (I don’t remember exactly what anymore) so that when it tried to digest anything other than mother’s milk, they stopped working right. Basically, it couldn’t digest the puppy food, and the vet said it was highly unlikely that any diet could keep it healthy, or even alive so we did have it put down.

I don’t think it’s swimmers - I looked at the pictures and didn’t see any signs of it. You can really tell almost from day one, as the affected pups look “flat” and their legs stick out to the sides.

Sorry to be no real help! Olive is cute tho!

You can buy basic dewormers in many pet stores here in the US but I don’t know about Japan. What they normally give puppies is called Strongid and if I remember correctly it’s .1cc per pound but definitely don’t take my word on that. See if you can buy it anywhere online or something? It can’t hurt if given at the proper dose. And I’ve heard horror stories about vets in Japan unfortunately. There’s no reason not to deworm a puppy or kitten if you don’t see worms and absolutely ridiculous not to vaccinate them afterwards.

And do they carry Science Diet in Japan? a/d is specifically for underweight animals and has a high calorie count. We used to feed it to underweight scraggly kittens in the shelter all the time. I hope your puppy does ok :frowning:

We put her down today :(. Her condition was continuing to deteriorate, and when we got to the vet her temp was down to 97f, even laying on a heating pad all the way there and for hours before. Her blood pressure was so low they couldn’t draw blood to do bloodwork (which I was reluctant to do in the first place, for the reasons mentioned above). She had blood in her stool last night, and looked like she was developing pnemonia. I thought I was prepared for it, and I’m pretty sure it was the right thing to do, but it was still very difficult. RIP, Blitzen.

The other puppies, thank og, continue to thrive.

I’m sorry to hear that Blitzen is gone. Sending good vibes for the rest of the kids!